Brainstem-type Lewy body disease presenting with progressive autonomic failure and lethargy

Clin Auton Res. 2000 Jun;10(3):139-43. doi: 10.1007/BF02278018.


The authors report an autopsy case characterized by progressive lethargy and autonomic failure with a distinctive pattern of occurrence of Lewy bodies. Autonomic dysfunction such as sleep apnea, orthostatic hypotension, dysuria, and hypohidrosis predominated with lethargy, whereas parkinsonism was not apparent. Numerous Lewy bodies were widely evident microscopically in brainstem nuclei and the intermediolateral cell columns of the spinal cord, as well as in the sympathetic ganglia, but were rare or absent in the cerebral cortex and other supratentorial structures. Marked neuronal loss was seen in the locus ceruleus, raphe nuclei, dorsal vagal nuclei, and intermediolateral cell columns, but neurons in the substantia nigra, other brain regions, and sympathetic ganglia appeared undiminished. This case represents a specific clinicopathologic form of Lewy body disease occurring predominantly in the brainstem, spinal cord, and sympathetic ganglia.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autonomic Nervous System / physiopathology
  • Autonomic Nervous System Diseases / etiology*
  • Autonomic Nervous System Diseases / physiopathology
  • Brain Stem* / pathology
  • Humans
  • Lewy Body Disease / complications*
  • Lewy Body Disease / pathology
  • Lewy Body Disease / physiopathology*
  • Male
  • Middle Aged
  • Sleep Stages*